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Parental Substance Use in New Hampshire: Who Cares for the Children?

June 5, 2018

Hidden in the shadows of New Hampshire's opioid epidemic are the children who live with their parents' addiction every day. They fall behind in school as the trouble at home starts to dominate their lives, they make the 911 calls, they are shuttled about to live with relatives or in foster care, and they face an uncertain future when their parents can no longer care for them.

As Opioid Use Climbs, Neonatal Abstinence Syndrome Rises in New Hampshire

December 19, 2017

The opioid crisis besetting every region of the United States directly affects more than just those who use substances. For a pregnant woman, a consequence of substance use can be neonatal abstinence syndrome (NAS)—withdrawal symptoms experienced by the newborn.

Paid Family and Medical Leave in New Hampshire

September 20, 2016

Life events such as an illness, the birth of a child, or a parent's need for care require workers to take extended time away from their jobs. The aging of the New Hampshire population and the rise of women in the labor force mean that more workers in the state are likely to need extended time away from work to provide family care. But taking the leave often means loss of pay or even loss of a job.Access to paid family and medical leave is uneven in New Hampshire. Neither the federal government nor New Hampshire have a paid family and medical leave law or program, thus access to leave depends on whether it is included as a benefit offered by one's employer. The 1993 Family and Medical Leave Act (FMLA) allows certain workers to take up to 12 weeks of unpaid—but job-protected—leave to tend to a serious health condition or to care for a new child or a seriously ill relative within a 12-month period. To be eligible for FMLA, employees must work for an employer with 50 or more workers within a 75-mile radius and have worked 1,250 hours for the same employer over the previous year. Nationally, about 41 percent of employees are not covered by FMLA. In New Hampshire, 10 percent of firms employing fewer than 10 employees provided paid family care leave in 2011; among businesses employing 250 or more employees, 30 percent provided paid family care leave. Many men face stigma for taking leave, as cultural and workplace attitudes typically view men as breadwinners and women as caregivers. Indeed, in New Hampshire, women are more likely to take family and medical leave (paid or unpaid), yet they are less likely to have access to the benefit, according to 2016 Granite State Poll data. Furthermore, workers with the lowest family income lack access to paid leave. The current system, reliant on employer-provided paid leave and unpaid FMLA, is fragmented and unequal, with some workers having access to generous paid leave benefits and others either cobbling together paid and unpaid leave, leaving the labor force, or not providing the needed family care.

Over 80 Percent of New Hampshire Residents Support Paid Family and Medical Leave Insurance

August 31, 2016

Paid family and medical leave helps workers manage their work and family responsibilities by allowing them to take extended time away from work while receiving some wage replacement and without the threat of being fired. Yet, access to paid family and medical leave to care for a sick family member, a new child, or tend to one's own illness is uneven: workers who typically have access are more likely to be full time, have higher education and earnings, and work in larger firms than workers with no access. Support for a statewide paid family leave program is widespread in New Hampshire. In a winter 2016 Granite State Poll, 82 percent of New Hampshire residents said they support a paid family and medical leave insurance program.Although New Hampshire currently does not have a paid family and medical leave law or program, these policies are gaining momentum across the United States. California, New Jersey, Rhode Island, and New York have enacted family and medical leave legislation (the New York law takes effect in January 2018), and many other states are considering similar legislation.At the federal level, the Family and Medical Insurance Leave Act (the FAMILY Act) would create a national paid family and medical leave insurance program to provide workers with time to care for family members, a new child, or themselves when seriously ill. Understanding the level and nature of support for a program in New Hampshire will provide policy makers and stakeholders with useful information when considering the needs of Granite State workers and the opportunities for maintaining a strong workforce.

Fewer Than Half of WIC-Eligible Families Receive WIC Benefits

July 20, 2016

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) serves millions of low-income women, infants, and children who are at nutritional risk by providing checks or vouchers for nutritious foods, nutrition counseling, breastfeeding support, and health care referrals. Foods eligible for WIC are high in certain nutrients and designed to meet the special nutritional needs of low-income pregnant, breastfeeding, or postpartum women, as well as infants and children up to age 5.Research has shown that WIC is a successful and cost-effective program. Numerous studies find that WIC participation improves pre- and postnatal health outcomes; families' overall nutrition; access to prenatal care, health care for children, and immunizations; and children's cognitive development and academic achievement.In 2015, the average monthly WIC benefit was $43.58 per person. Easing the costs associated with buying nutritional foods frees up family resources for other necessities, like housing and medical costs. Families with pre-tax incomes up to 185 percent of the federal poverty line are eligible for the program. WIC benefits are especially important for rural families, as the poverty rate is higher in rural than in urban areas (18 percent compared with 15 percent in 2014). It is important to consider uptake differences by place type as research indicates that rural women perceive more stigma surrounding participation in government assistance programs compared with women in urban areas.

After a Parent Left Employment, One in Five Children Lost Private Insurance

May 24, 2016

Parental job loss is an important trigger for a child's loss of private health insurance. For example, research shows that parental loss of full-time employment doubles the odds that a child will lose private health insurance. Until the 1990s, substantial numbers of children lacked health insurance, but with the enactment of the Children's Health Insurance Program (CHIP) in 1997, followed by changes to Medicaid and CHIP's 2009 reauthorization, children's health insurance coverage was expanded through broader eligibility, enrollment simplifications, and outreach efforts. From 1997 to 2012, the share of children without insurance fell from 14 percent to 7 percent.The growth of public coverage for children notwithstanding, private coverage is still the primary form of children's health insurance. In 2014, 59 percent of children received coverage from private health insurance. But coverage has become less consistent for some children, due to an overall decline in employer-provided private-sector coverage, an increase in switching between public and private sources, and low public health insurance renewal rates. Even brief gaps in health insurance produce adverse consequences for children, including fewer medical provider visits over the course of a year, the loss of a primary health care provider, difficulty getting preventive and specialized medical care, and the increased use of emergency department and inpatient hospital visits. Loss of employer-based coverage leads to instability in health insurance, gaps in coverage, and more unmet health care needs.This brief focuses on children's loss of private health insurance after a parent left his or her job voluntarily or involuntarily between May 2008 and the end of 2012 (see Box 1 for definitions). The number of uninsured children declined steadily throughout this period, and experts project that some of the provisions of the Patient Protection and Affordable Care Act (ACA) of 2010 will foster a continued decline in the percentages of children without health insurance over the long term. For most of the period under study, many ACA provisions that have likely served to expand coverage—the mandate that persons obtain health insurance, the state option to expand Medicaid to reach more families, the provision of federal subsidies to purchase coverage, and the ACA requirement for states to transition coverage of children up to 138 percent of the federal poverty line from CHIP to Medicaid—had not yet gone into effect. But since most children are still covered under private health insurance plans, the majority of which are linked to the parents' employment, understanding the relationship and the characteristics of children who are unlikely to remain covered after a parent leaves his or her job may help identify ways to preserve consistency in coverage. For example, health care providers, administrators, and policy makers can keep watch to ensure that eligible children are quickly connected with public sources of coverage.

Women As Economic Providers: Dual-Earner Families Thrive As Women’s Earnings Rise

June 30, 2015

Women's contributions to family income are essential for most families. This is obviously true for the growing number of single-mother families, but increasingly so for married couple families. While dual-earner families are doing relatively well, family income overall has been stagnant or decreasing among single-earner families, resulting in a widening income gap. This study provides an examination of married and single women's contributions to family income. Single women are comprised of those who are cohabiting, in same sex marriages, living alone, with parents or other family members, or living with roommates. In this brief, we consider family income for all single and married women. In the case that single women live alone or with nonrelatives, family income is comprised of the woman's income.

After Great Recession, More Married Fathers Providing Child Care

February 3, 2015

The U.S. economy lost 8.7 million jobs between December 2007 and January 2010. Sixty-nine percent of the jobs lost during the recession were held by men, and the employment rate of married fathers (whether working full or part time) with employed wives decreased from 92 percent in 2005 to 88 percent in 2011. The large job losses and persistently high unemployment from the Great Recession and its aftermath prompted families to adapt to financial hardship and reallocate fathers' and mothers' time spent in the labor force and in the home.

Families Continue to Rely on Wives As Breadwinners Post-Recession

July 24, 2014

The negative outcomes of the Great Recession have been multifaceted, affecting many areas of family economic well-being. The U.S. economy lost 8.7 million jobs between December 2007 and January 2010. Although the recession officially ended in June 2009, the national unemployment rate remains approximately 1.5 percentage points higher than the pre-recession rate, even though the total number of jobs lost duringthe recession has been recovered. Similarly, long-term unemployment is prevalent, with length of unemployment averaging 37.1 weeks. Furthermore, involuntary part-time work increased during the recession and hasremained relatively constant. These statistics translate into continued hardship for many Americans, exemplified in the decline in median household income since the onset of the Great Recession.

Child Care Subsidies Critical for Low-Income Families Amid Rising Child Care Expenses

May 21, 2013

President Obama in his 2013 State of the Union address called for making "high-quality preschool available toevery child in America" and laid out a plan to invest in young children and support low-income working families. This plan proposed a joint federal-state partnership to provide high-quality public preschool for all four-year-old children from low-income families (which include poor families), as well as an increase in investments in Head Start programs and an expansion of early care and education programs for infants and toddlers. The President's budget includes increased funding in fiscal year 2014 to expand and improve infant and toddler care and to increase child care subsidies to help low-income families pay for child care.In addition, the U.S. Department of Health and Human Services recently proposed new regulations to ensure children's health and safety and improve the quality of child care among child care providers who accept child care subsidies for low-income families through Child Care and Development Fund (CCDF) funds. 

Low Wages Prevalent In Direct Care and Child Care Workforce

November 21, 2007

The large scale movement of women into the paid labor market has brought sweeping change to the structure of family life, affecting who cares for the elderly and children. Today, our society depends, in part, on the caring work of many paid professionals and, as the number of elderly and children grow as is predicted by demographers, our society will increasingly depend on these workers. This policy brief examines the economic well-being of workers in two low-wage, predominantly female care giving occupations plagued with high turnover -- direct care workers (personal care assistants, home care aides, home health aides, and certified nursing assistants) and child care workers (preschool and nursery school teachers, center-based child care providers, and home-based family child care providers). High turnover in both the direct care and child care workforce contributes to lower quality care leading to unfavorable outcomes for the elderly and children. Although these paid caregivers are employed, hourly wages are low and many live in low-income families and lack health insurance. Furthermore, research shows that those who work in occupations involving care work face a wage penalty, that is they earn less than expected based on their job characteristics and qualifications.

Employment Rates Higher Among Rural Mothers Than Urban Mothers

September 24, 2007

As men's jobs in traditional rural industries such as agriculture, natural resource extraction, and manufacturing disappear due to restructuring of rural labor markets, the survival of the family increasingly depends on women's waged labor. Rural mothers with children under age 6 have higher employment rates than their urban counterparts, but have higher poverty rates, lower wages, and lower family income, placing rural mothers and their children in a more economically vulnerable situation than urban mothers. The entry of rural women, and particularly rural mothers, into the paid labor market is important to consider in light of recent research that finds rural children lagging behind urban children in letter recognition or beginning sounds recognition when entering kindergarten.Good quality child care enhances early brain development, cognitive and language development, and school readiness, setting the stage for successful early school achievement. As more rural mothers enter the workforce, ensuring good quality child care is critical because child care providers play an important role in promoting child development, especially for preschoolers, whose early life experiences play a fundamental role in their development.